NRS 689B.0285
System for resolving complaints: Approval

  • requirements
  • examination.

1.

Except as otherwise provided in subsection 4, each insurer that issues a policy of group health insurance in this State shall establish a system for resolving any complaints of an insured concerning health care services covered under the policy. The system must be approved by the Commissioner.

2.

A system for resolving complaints established pursuant to subsection 1 must include an initial investigation, a review of the complaint by a review board and a procedure for appealing a determination regarding the complaint. The majority of the members on a review board must be insureds who receive health care services pursuant to a policy of group health insurance issued by the insurer.

3.

The Commissioner may examine the system for resolving complaints established pursuant to subsection 1 at such times as the Commissioner deems necessary or appropriate.

4.

Each insurer that issues a policy of group health insurance in this State that provides, delivers, arranges for, pays for or reimburses any cost of health care services through managed care shall provide a system for resolving any complaints of an insured concerning the health care services that complies with the provisions of NRS 695G.200 to 695G.310, inclusive.

Source: Section 689B.0285 — System for resolving complaints: Approval; requirements; examination., https://www.­leg.­state.­nv.­us/NRS/NRS-689B.­html#NRS689BSec0285.

Last Updated

Feb. 5, 2021

§ 689B.0285’s source at nv​.us